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General NPI Number Information
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NPI Number | 1144216953
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Entity Type | Individual
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Provider Name | MARY LOUISE LENAHAN MD
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Gender | Female
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Dates
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Enumeration Date | 09/27/2005
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Last Update Date | 05/20/2019
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Provider Practice Location Address
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Address Line | 6507 TRANSIT RD
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City | EAST AMHERST
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State | NY
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Zip | 14051-1427
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Country | US
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Telephone | 716-689-4377
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Fax | 716-689-4843
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Provider Business Mailing Address
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Address Line | 6507 TRANSIT RD
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City | EAST AMHERST
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State | NY
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Zip | 14051-1427
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Country | US
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Telephone | 716-689-4377
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Fax | 716-689-4843
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | 153446-1
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License Number State | NY
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